Working Paper: NBER ID: w16720
Authors: Itai Ashlagi; Alvin E. Roth
Abstract: As multi-hospital kidney exchange clearinghouses have grown, the set of players has grown from patients and surgeons to include hospitals. Hospitals have the option of enrolling only their hard-to-match patient-donor pairs, while conducting easily arranged exchanges internally. This behavior has already started to be observed. \n \nWe show that the cost of making it individually rational for hospitals to participate fully is low in almost every large exchange pool (although the worst-case cost is very high), while the cost of failing to guarantee individually rational allocations could be large, in terms of lost transplants. We also identify an incentive compatible mechanism.
Keywords: No keywords provided
JEL Codes: C78; D02; I11
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| design of kidney exchange mechanisms (D47) | hospital participation (I11) |
| participation in centralized exchanges (E42) | number of transplants (F24) |
| failure to guarantee individually rational allocations (D71) | significant losses in transplants (F24) |
| hospitals matching hard-to-match pairs internally (I11) | reduce overall number of transplants (C24) |
| number of hospitals and incompatible pairs is small (I11) | cost of guaranteeing individual rationality can be substantial (D80) |
| larger markets (D40) | cost of guaranteeing individual rationality diminishes significantly (D80) |